Monday, 9 November 2009

Patients in middle age are to be offered an NHS health check every five years, Gordon Brown will announce today. By 2012, everyone aged 40 to 74 will be entitled to free checks to assess their risk of heart disease, stroke, diabetes and kidney disease as part of an extension of patients’ rights being proposed by the Government.

I hope you don't mind if I politely decline your offer, Gordon, and suggest that you poke your health checks somewhere snug - sideways. Is that OK with you, chummy?

Now, apart from the obvious question as to why these checks are emphasised as being 'free' in a health service which, as they sell it to us, is very much supposed to be exactly that anyway - how are these checks going to be any different from the usual NHS interactions which I have been avoiding for quite a while now**?

Appointments would generally go something like this:

Doc: (head down, writing notes) So what's the problem?DP: I've an ingrowing toenail/aching elbow/itchy knob (delete as applicable).Doc: (not looking up) Do you smoke?DP: Yes, but ...Doc: (still not looking up) You shouldn't. It's bad for your health ... (nag for a bit, throw in a few scare stats)DP: Well, I ...Doc: (still no eye contact) Here's a prescription for antibiotics. Take twice daily. See the receptionist on your way out for the local smoking cessation service. Good day.

I pay around £4k pa for this exceptional level of 'free' service, a service I no longer use due to the tiresome finger-wagging and hectoring involved, as well as the generally poor reception afforded.

I've tried hinting that the Doc should keep his/her nose out, pointed out that doctors kill quite a few themselves, that sort of thing, all to no avail. So I don't have a regular check up routine anymore.

The last time I was made to, reluctantly, use the NHS was for a compulsory medical related to a licence I needed, as part of this government's policy of requiring us to ask their permission before embarking on any business activity whatsoever. That, of course, wasn't free - I had to pay £75 for it. The procedure lasted approximately 10 minutes (a tasty £450 per hour), or should have done, except that I didn't lie on the question of what I drink at weekends. As a result, the nurse went all wobbly and said she would have to wait for a Doctor to sign it off as I was exceeding government alcohol unit guidelines. As all of them were busy with appointments, I was sat waiting for over 20 minutes in the room - and you won't believe this, but trust me it's absolutely true - with a Chow dog sporting a big white collar round its neck, as nursey had explained at the start that her dog was sick and she didn't have anywhere else to take him ... except a doctor's examination room, natch.

Tempting as such classy care is, I don't feel the need to volunteer for more of the same with Gordon's new initiative. I'm sure there will come a time when I certainly will need the NHS that I pay a barrowload of readies for each month, but it's looking increasingly likely that, by then, they will routinely deny me the treatment for which I have paid, on the spurious grounds that my lifestyle is somehow costing the country money ... after ignoring the many tens of thousands of pounds I have paid into the system since starting work in 1985.

So, Gordon, whilst you may believe this to be a stonking idea, 'free' health checks don't really work for me, sunshine. Unless and until, that is, you instruct GPs and other health professionals to just check me over, fix me if required, and shut the fuck up about my personal choices.

Either that, or you could give me my bloody money back and let me arrange my own health cover with a company who will treat me as the high-paying customer that I am, instead of some burdensome miscreant to be vilified and treated with contempt.

** My fears about the NHS began in the 80s when, following a routine GP check up, I received a letter from the surgery stating that I was pregnant.

Went to dentists. Asked to fill in health questionnaire. "Do you smoke? How many per day?" Went to doctors (as you say). "Do you smoke, etc?". Went for flue jab. "Just need to update records on computer. Do you smoke etc?" Note the lack of questions such as, "Do you have unprotected homosexual sex? Do you inject heroin? Etc".

A couple of years ago, I had a letter from my doctor asking me to go for a check-up (presumably because I was aged 68) for blood pressure and other things. I wrote back and declined because my family history did not indicate any problem and I felt perfectly healthy and in any case I really did not want to know because travel insurance companies and others have a habit of hitting you with substantially increased premiums for 'pre-existing conditions'.

The problem is that we really, really trust our doctors. Only recently have we become aware that they are being FORCED by the state to ask these questions. I have in mind to decline to answer these questions about smoking or, indeed, any other questions which are not directly related to my current health issue (for once, the word 'issue' is appropriate).

Oddly enough, I wellcome the PM's initiative to give people over 40 (but why 'up to 74 - why not beyond 74?) the 'entitlement to free checks..'. What worries me is that the phrasiology is hiding some intended enforcement. (It is easy to see how failure to take advantage of an invitation from your doctor to attend the surgery for a 'free' check-up could be construed as 'self-inflicted injury' in the event that one becomes ill as a result of some pre-existing condition which might have been spotted in such a check-up). I suspect that this basic thought (enforcement) may be subconsciously in your thinking that GB can stuff his free check-ups up his arse. However, if the idea is a genuine one, then I see no downside to it.

Isn't it awful that we have been put into a position where we have to think these thoughts? It really is.

"It is easy to see how failure to take advantage of an invitation from your doctor to attend the surgery for a 'free' check-up could be construed as 'self-inflicted injury' in the event that one becomes ill as a result of some pre-existing condition which might have been spotted in such a check-up"

That thought had crossed my mind too. And I'm not certain that it hasn't crossed Gordon's as well, considering the 'advisers' the government surrounds itself with.

These tossers are so used to people admitting to one third of their true consumption.

For example "Yes, the occasional cigarette in the pub on a Friday, two pints of beer. And maybe a glass or two of wine on a Sunday afternoon" goes down on the patient records as "Heavy smoker, heavy drinker".

When they asked me, I told them "About twenty-five roll-ups and five or six cans of lager."

"Per week or per day?"

"No, that's per day."

Followed by visible discomfort on the part of GP mentally trying to calculate 5 x 3 x 7 and then realising that no way could a normal human being get through 500 roll-ups or 100-plus cans a week.

My dentist asked me about smoking, drinking, sugar and fatty foods. I told him that I resented this line of questioning as I was paying for him to carry out a check up on my teeth and not on my lifestyle. He agreed with me as he is a 20+ a day smoker and loves red wine and good food. He says he is generous with the truth about it when he goes to the doc etc. Unfortunately it is on their computer systems and they have to ask the questions. There followed somewhat of a rant/debate - well, he did and I joined in as much as I could in between the actual check up.....

Anyway, this whole free health check thing is a bloody farce. I agree that there is something very sinister behind it all - this guv gives nothing for free without a plot sitting behind the scenes.

BTS, thought that was normal intake for you - except the cans would be vodka ;-)

"Unfortunately it is on their computer systems and they have to ask the questions."

Indeed. To get the medical I required, I had to sign up with my local GP surgery as I hadn't had one in my previous two addresses. As part of the process, I was required to go for a quick check up with a different, more relaxed, nurse. She mentioned smoking cessation and must have seen me bristle and raise my hackles as she qualified it by stating "we are required to say that".

She was OK and dropped it straight away, but prejudice dictates that many doctors hate tobacco so much that they instinctively switch off if you are an unapologetic smoker.

Equal health care for all is then instantly compromised by personal views. In a private system, they would lose a customer and their approach would have to change for fear of a P45. The NHS doesn't work like that, of course.

Junican: I go to a private dentist that I can ill-afford (£30 every six months isn't too bad, but it's the fillings that are the killer... so I look after my teeth; do you see how this works, Gordon?). He's never asked me about smoking, drinking, or my sexual preferences. Largely because he knows he'd immediately lose a patient.

I knew something was up with the NHS when I received a letter from my GP in MS Comic Sans. Not only do they talk to you as if you were in primary school, they write to you like that as well now.